Scribd
Upload
659 views3 pages

Scenario Based Question: Answer

The document describes a scenario where a nurse is visiting a family and notices their 18-year-old daughter, Reema Gurung, looks pale, thin, and weak. Her mother says she feels dizzy and has breathing problems. The nurse would assess Reema's family history, past medical history, and symptoms. The nurse would perform a hemoglobin test using the Tallquist method. The nurse would educate Reema and her family that she likely has iron deficiency anemia due to low iron intake. The nurse would recommend treating anemia with an iron-rich diet and oral iron supplements taken with vitamin C and followed for months.

Uploaded by

Praty Sawaden
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
659 views3 pages

Scenario Based Question: Answer

The document describes a scenario where a nurse is visiting a family and notices their 18-year-old daughter, Reema Gurung, looks pale, thin, and weak. Her mother says she feels dizzy and has breathing problems. The nurse would assess Reema's family history, past medical history, and symptoms. The nurse would perform a hemoglobin test using the Tallquist method. The nurse would educate Reema and her family that she likely has iron deficiency anemia due to low iron intake. The nurse would recommend treating anemia with an iron-rich diet and oral iron supplements taken with vitamin C and followed for months.

Uploaded by

Praty Sawaden
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

Scenario Based question

1. During a home visit, you met a family consisting of 5 members. While collecting
history of all the family members you observed that the daughter named Ms. Reema
Gurung age 18 years was looking very pale, thin and weak. So, after further asking
her mother said that she is very weak, feels dizzy most of the time and sometimes
also have breathing problem.

a) What you will assess in the client?

b) What care you will perform and write the steps. (any method)

c) What health education on treatment and prevention you will provide to the
client?

ANSWER
a) Following points should be assessed in the client:
 Family history of illness,
 History of past illness,
 Time since the first signs and symptoms occurred.
b) Care to be performed: Hemoglobin estimation (Tallquist method)
Steps of tallquist method:
Explain the procedure to the client.
Ask the client to wash hands.
Clean the ring finger of the non-dominant hand with spirit swab.
Prick the finger and clean the first drop with dry cotton swab.
Press the finger below the prick to have a big drop and take it on a
doubled piece of blotting paper.
Press the pricked area with another spirit swab.
Let the blotting paper dry for 30 seconds.
Discard the lancet.
Match the color of blood on bloating paper with that of the tallquist
scale in good light. If the color code does not match properly or is in
between two readings; take lower one.
Discard the blotting paper in paper bag.

c) HEALTH EDUCATION
Anemia: A condition in which the hemoglobin level is lower than normal.
Three broad categories:
1. Loss of RBC- occurs with bleeding
2. Decreased RBC production
3. Increased RBC destruction
 Iron Deficiency Anemia
– Results when the dietary intake of iron is inadequate to
produce hemoglobin
Etiological Factors;
– Bleeding: the most common cause
– Mal-absorption
– Malnutrition
– Alcoholism

Pathophysiology
– The body stores of iron decrease, leading to depletion of
hemoglobin synthesis
– The oxygen carrying capacity of hemoglobin is reduced
tissue hypoxia

Assessment Findings:
 Pallor of the skin and mucous membrane
 Weakness and fatigue
 General malaise
 Brittle nails
 Smooth and sore tongue
 Angular cheilosis
Laboratory findings:
 CBC: Low levels of Hct, Hgb and RBC count
 low serum iron, low ferritin
 Bone marrow aspiration- MOST definitive
Medical management
 Hematinics: Any substance that tends to increase amount of
hemoglobin in the blood. E.g., iron, B12, and folate.
 Blood transfusion
Nursing Management:
1. Provide iron rich-foods
– Organ meats (liver)
– Beans
– Leafy green vegetables
– Raisins and molasses
2. Administer iron:
– Oral preparations tablets- Fe fumarate, sulfate and gluconate
– Advise to take iron ONE hour before meals
– Take it with vitamin C
– Continue taking it for several months
– Oral preparations- liquid
– It stains teeth, Drink it with a straw
– Stool may turn blackish- dark in color
– Advise to eat high-fiber diet to counteract constipation
– IM preparation
– Administer DEEP IM using the Z-track method
– Avoid vigorous rubbing
– Can cause local pain and staining
Submitted by
Praty limbu
Regd. No 201909085
2nd year bsc nursing

You might also like